Provider Demographics
NPI:1558528877
Name:LOVE, KEVIN MICHAEL (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:MICHAEL
Last Name:LOVE
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DOVE AVENUE
Mailing Address - Street 2:SHAUGHNESSY-KAPLAN REHABILITATION HOSPITAL
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2944
Mailing Address - Country:US
Mailing Address - Phone:978-825-8637
Mailing Address - Fax:
Practice Address - Street 1:1 DOVE AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2944
Practice Address - Country:US
Practice Address - Phone:978-825-8637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3793225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist